Worse Than Death Panels

During the debate over ObamaCare, more than one critic charged that government panels would make life and death decisions affecting patient care.

Now it seems the Obama administration is contemplating something that is even scarier: doctors would be given immunity from malpractice lawsuits, but only if they practice medicine according to government guidelines. The pressure would be enormous. Have you ever met a doctor who wanted to be sued?

The original "death panel" charges were not entirely baseless. Former Senator Tom Daschle, who wrote the blueprint for health reform, advocated a "comparative effectiveness" agency that would decide which medical procedures were worthwhile and which ones were not. As a model, Dashiell pointed to the National Institute for Comparative Effectiveness (NICE) in Britain. How are patients faring under that regime? According to the World Health Organization, about 25,000 British patients die prematurely every year because they do not have access to cancer drugs that are routinely available in the United States and continental Europe.

There is no similar agency with comparable powers under ObamaCare. But there are many ways in which the same results can be achieved indirectly. For example, Medicare has announced it will start paying more to hospitals that follow a dozen procedures, including administering antibiotics prior to surgery and anticlotting medication to heart attack patients. It will pay less to hospitals that don’t comply. The same thing is about to happen to doctors. Those who comply on up to 194 different metrics — including adopting electronic medical records — will get higher fees. Those who resist will get lower ones.

These are examples of a much larger trend: Washington telling the medical community how to practice medicine. Even though a recent study finds little relationship between the inputs Medicare wants to pay for and such outputs as patient survival, and even though the latest pilot programs show that paying doctors and hospitals for performance doesn’t improve quality, we are about to usher in the era of big brother medical care.